ムショウ シンリョウジョ ノ カンリエイヨウシ ハイチ ニ タイスル セイカツ シュウカンビョウ カンジャ カラ ノ ニーズ ニ ツイテ

【目的】これまで我々は、無床診療所医師を対象とした調査を行い、管理栄養士による栄養指導が普及していない理由として、「患者からのニーズがない」という意見が多くあることを明らかにした。一方、無床診療所の管理栄養士配置に対する患者からのニーズを調査した成績はない。そこで今回、無床診療所の管理栄養士配置に対する生活習慣病患者からのニーズを明らかにすることを目的とした。【方法】東大阪地域の市民祭りや老人クラブの活動拠点に集まった方のうち、糖尿病や高血圧症などの生活習慣病を患い、病院もしくは診療所に通院されていた245 名を対象として、聞き取り式のアンケート調査を行った。【結果】管理栄養士の名称や業務を認知していた者は75.1％（184/245 名）であった。このうち「管理栄養士を無床診療所に配置する必要がある」と回答した者は70.7％（130/184 名）であり、その理由として「食生活について身近に相談できる人がいると嬉しい」「食の専門家である管理栄養士の意見を聞きたい」という意見が多くみられた。一方、「管理栄養士を配置する必要がない」と回答した者は16.3％（30/184 名）であり、その理由として「他の医療従事者による栄養指導で十分」「自分自身で食事管理できる」という意見が多くみられた。また、「どちらでもない」と回答した者は13.0％（24/184 名）であり、その理由として「管理栄養士を置く必要性が分からない」という意見が多くみられた。【結論】今回調査した地域における無床診療所の管理栄養士配置に対する生活習慣病患者からのニーズは、約7 割と高いものであった。今後は無床診療所医師に対する普及活動や、管理栄養士の役割を理解できていない患者に対する啓発活動が必要である。In this study, we aimed to clarify the needs of patients suffering from lifestyle related diseases, to determine the perceived role and importance of a registered dietitian placement in a non bed clinic. A previous survey of non bed clinic physicians suggested that nutritional guidance provided by registered dietitians was not valued in the clinical setting; many physicians felt that “there is no need for the patient” to receive dietary advice from registered dietitians. However, no research has examined patients’ perspectives regarding the placement of a registered dietitian in a non bed clinic.Methods: We conducted a questionnaire with 245 participants suffering from lifestyle related diseases such as diabetes and hypertension. They were recruited from those who gathered in the activity base of a civic festival, and from a seniors club in the Higashi Osaka region. All of the participants had visited the hospital or clinic at one time.Results: Of the 245 participants, 184 (75.1%) had been advised by a registered dietitian. The opinion that “a registered dietitian needs to be placed in a non bed clinic” was expressed by 70.7% (130 of 184) of those surveyed. Many wanted “to hear the opinion of a registered dietitian who is an expert on food” and gave reasons such as, “I’m happy to have people who can consult closely with me about my diet.” By con- trast, 30 of the 184 participants (16.3%) responded that “there is no need to place a registered dietitian” in a non bed clinic. They believed that “the nutritional guidance offered by other health care workers was enough” or that “their own opinion” provided adequate dietary management. Finally, 24 (13.0%) participants answered “Neither,” giving “I do not know whether there is a need to place a registered dietitian” as their reason.Conclusions: It needs from lifestyle related diseases a patient to a registered dietitian placement of the non bed clinic in conclusion was this time the study area were those about 70% and higher. Based on our findings, we suggest that in future dissemination activities, including those provided by non bed clinic doctors, there is a need for awareness raising for patients who do not understand the role of registered dietitians in a non bed clinic setting

Oral Supplementation of the Vitamin D Metabolite 25(OH)D(3)Against Influenza Virus Infection in Mice

Vitamin D is a fat-soluble vitamin that is metabolized by the liver into 25-hydroxyvitamin D [25(OH)D] and then by the kidney into 1,25-dihydroxyvitamin D [1,25(OH)(2)D], which activates the vitamin D receptor expressed in various cells, including immune cells, for an overall immunostimulatory effect. Here, to investigate whether oral supplementation of 25-hydroxyvitamin D-3[25(OH)D-3], a major form of vitamin D metabolite 25(OH)D, has a prophylactic effect on influenza A virus infection, mice were fed a diet containing a high dose of 25(OH)D(3)and were challenged with the influenza virus. In the lungs of 25(OH)D-3-fed mice, the viral titers were significantly lower than in the lungs of standardly fed mice. Additionally, the proinflammatory cytokines IL-5 and IFN-gamma were significantly downregulated after viral infection in 25(OH)D-3-fed mice, while anti-inflammatory cytokines were not significantly upregulated. These results indicate that 25(OH)D(3)suppresses the production of inflammatory cytokines and reduces virus replication and clinical manifestations of influenza virus infection in a mouse model